Whether you are placing a grommet in an eardrum or positioning an epidural needle in the back, it is in everyone’s interest to get to the point quickly.

Two Cork-based start-ups are looking to help physicians with those tasks and they had to get to the point quickly themselves earlier this month when they made rapid pitches to potential partners and investors at a ‘MedTech Idol’ competition in Dublin.

Thirty-six early-stage medical device companies entered the international contest and AventaMed and Produral were among just four finalists to take the stage for the MedTech Idol competition organised by RCT Ventures at the Informa Investment in Innovation (IN3) Medical Device 360° Dublin conference.

One-stop device for grommetsAventaMed, which the audience voted the overall winner, is developing a one-stop device for quickly inserting grommets into the eardrum.

“The vast majority of grommet procedures are on children and that currently involves a general anaesthetic in an operating room with a surgical team,” says chief executive Olive O’Driscoll, who presented at IN3.

“The surgeon typically uses several instruments to make an incision [in the eardrum] and to manoeuvre this tiny tube, or grommet, which is about the size of half a grain of rice, into place.”

O’Driscoll and AventaMed’s chief technology officer John Vaughan hit on the idea of a single-use, disposable device that could be used outside an operating theatre and without the need to put the patient under general anaesthetic.

The resulting hand-held instrument is pre-loaded with a grommet and the device gets thrown away when the job is done.

“The surgeon just inserts this one instrument into the ear and the business end of the device holds the grommet itself,” Vaughan says. “A tiny needle makes an incision in the eardrum and, once the surgeon presses the button, it will release the grommet into place in the membrane.”

Ears to the future and timing is rightThe start-up, from the Medic centre at Cork Institute of Technology, developed the device using 3D-printing technology and is currently gearing up for clinical testing later this year. O’Driscoll foresees ear, nose and throat surgeons using the device even for young children.

And the timing is good for AventaMed to win the competition, earning the start-up a presenting slot at the IN3 Medical Device 360° Summit in San Francisco in November.

“We have just started our fundraising round, so I couldn’t think of a better way to showcase our technology to patients, surgeons and investors,” O’Driscoll says.

Eyeing up epiduralsIt is also important to hit the right spot when setting up an epidural – but how do you know when the needle is there? Missing the mark could mean headaches or other complications for the recipient, or it could mean the medication being delivered would not be effective.

“Physicians usually rely on feeling a small loss of pressure when they get into the epidural space,” explains Conor O’Shea, acting chief technology officer with the University College Cork-based start-up ProDural, “but it can take trainees quite a while to get the feel for this.”

O’Shea presented at the MedTech Idol final about the innovation, developed with Dr Pádraig Cantillon-Murphy at UCC and Dr Peter Lee, a consultant anaesthetist at Cork University Hospital.

It is a small, inflating diaphragm at the syringe’s tip designed to collapse when the needle is in place, so the physician has a visual cue as well as feeling the loss of pressure in the syringe, O’Shea says.

“If you can see the balloon collapse, immediately you will know you have reached the epidural space.”

So far, the device has been tested on cadavers. “We compared ProDural to an existing loss-of-resistance syringe in a number of areas advancing up along the vertebrae,” he adds.

“In each of the locations, ProDural positively identified the epidural space and our general feeling is that the immediate collapse improves the reaction time of the physician.”

O’Shea also stresses the relative simplicity of the approach.

“We initially looked at using sensors, but there are options out there that use complicated technologies and they have really struggled,” he says. “Anaesthetists are quite comfortable with the current way and this makes it a small bit better.”

ProDural is now looking to set up trials to see if the device reduces the time it takes for trainee anaesthetists to reach proficiency. The start-up has an eye to the US market for epidurals in obstetrics and to treat back pain, notes O’Shea.

Other finalists presenting at IN3 were Israel-based HeadSense with a non-invasive device for measuring intracranial pressure and US- and Dublin-based NeuroTronik, which is looking to use neuromodulation in heart failure.

Testing hurdleSecuring investment to bring medical devices through clinical testing is a major hurdle for start-ups, and getting the right investors on board makes all the difference, according to Dr Alan O’Connell, who is a partner at life sciences investment firm Seroba Kernel.

He was on the judging panel for MedTech Idol and says having four Irish companies in the top 10 – Produral, AventaMed, NeuroTronik and Dublin-based Incereb – is “particularly impressive and testament to the level of talent in the Irish med tech sector.”

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